Can Information Technology Improve Health care Equity in the United States? Lessons from Taiwan
Technology, Communication, Disparities and Government Options in Health and Health Care Services
ISBN: 978-1-78350-645-3, eISBN: 978-1-78350-636-1
Publication date: 15 September 2014
Abstract
Purpose
Over the last few decades, information technology (IT) has significantly altered the nature of work and organizational structures in many industries, including health care. The purpose of this analysis is to compare how system-level differences affect IT implementation in health care (HIT) and the implications of these differences for health care equity.
Methodology/approach
We critically analyzed selected claims concerning the capacity of HIT to provide better care to more individuals at lower costs, thus contributing to health care equity, in the context of current health care reform efforts in the United States. We used the case of HIT implementation in Taiwan’s National Health Insurance system as a contrasting case.
Findings
We argue that however much HIT may yield in quality improvements or savings in the context of a universal and publicly financed single payer system, such savings simply cannot be accrued by a system of multiple health plans competing for better customers (i.e., less costly patients) and driven by profit.
Implications
It is important to define the level of analysis in debates about the potential of HIT to produce better health care at lower costs and the equity implications of this potential. In these debates, US policy makers should consider the commitment to health care equity that informed the design of Taiwan’s health care system and of HIT implementation in that country. HIT merely provides enabling tools that are of little value without major systemic changes
Originality/value of the chapter
To our knowledge, the health IT expert literature has overlooked when not ignored the ethical principles informing health care systems, an omission which makes it difficult if not impossible to evaluate the potential of HIT to increase equity in health care.
Keywords
Acknowledgements
Acknowledgments
The authors thank Professor Cheming Yang, Professor Tzay-Jinn Chen, and Professor Patrick Fox for their careful reading of drafts and useful feedback. They also thank the faculty at Taipei Medical University and officials at the Bureau of National Health Insurance for sharing their knowledge and experience. Lastly, they thank the staff at the Institute for Health & Aging for their continuing, invaluable support.
Citation
Chaufan, C. and Li, Y.-C. (2014), "Can Information Technology Improve Health care Equity in the United States? Lessons from Taiwan", Technology, Communication, Disparities and Government Options in Health and Health Care Services (Research in the Sociology of Health Care, Vol. 32), Emerald Group Publishing Limited, Leeds, pp. 19-33. https://doi.org/10.1108/S0275-495920140000032000
Publisher
:Emerald Group Publishing Limited
Copyright © 2014 Emerald Group Publishing Limited